FURP.ORG / PUBLIC DATA EXPLORER

PLEASANT VALLEY HOSPITAL INC: Form 990, tax year 2019

View the entire original 990 at ProPublica ↗

Organization
PLEASANT VALLEY HOSPITAL INC (EIN 55-0440086)
Tax period
2019-10-01 to 2020-09-30
Filed
2021-08-16
IRS object ID
202132289349303303
Schema version
2019v5.2
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2021-08-16T14:07:45-05:00ReturnTs
Tax Period End2020-09-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN550486667PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1Arnett Carbis Toothman LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1P O Box 2629AddressLine1Txt
CityCharlestonCityNm
State AbbreviationWVStateAbbreviationCd
ZIP25329ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2019-10-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN550440086EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Pleasant Valley HospitalBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlPLEABusinessNameControlTxt
Phone3046754340PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line12520 Valley DriveAddressLine1Txt
CityPt PleasantCityNm
State AbbreviationWVStateAbbreviationCd
ZIP25550ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonCraig GillilandPersonNm
Person TitleCFOPersonTitleTxt
Phone3046754340PhoneNum
Signature2021-08-16SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonDolores RosePreparerPersonNm
PTINP01286262PTIN
Phone3043460441PhoneNum
FieldValueIRS element (for citing)
Tax2019TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerJeff NoblinPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line12520 Valley DriveAddressLine1Txt
CityPt PleasantCityNm
State AbbreviationWVStateAbbreviationCd
ZIP25550ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$78,750,876GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website Addresswww.pvalley.orgWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1955FormationYr
Legal Domicile StateWVLegalDomicileStateCd
Activity Or MissionProvide quality inpatient and outpatient healthcare to the community regardless of ability to pay. Provide a wellness center to promote community health through fitness programs.ActivityOrMissionDesc
Voting Members Governing Body18VotingMembersGoverningBodyCnt
Voting Members Independent17VotingMembersIndependentCnt
Total Employee734TotalEmployeeCnt
Total Volunteers0TotalVolunteersCnt
Total Gross UBI$173,787TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$130,124NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$41,030PYContributionsGrantsAmt
CY Contributions Grants$530,147CYContributionsGrantsAmt
PY Program Service Revenue$65,133,147PYProgramServiceRevenueAmt
CY Program Service Revenue$51,984,882CYProgramServiceRevenueAmt
PY Investment Income$117,593PYInvestmentIncomeAmt
CY Investment Income$598,166CYInvestmentIncomeAmt
PY Other Revenue-$230,769PYOtherRevenueAmt
CY Other Revenue$25,610,943CYOtherRevenueAmt
PY Total Revenue$65,061,001PYTotalRevenueAmt
CY Total Revenue$78,724,138CYTotalRevenueAmt
PY Grants And Similar Paid$6,076PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$62,078CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$34,015,030PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$30,352,264CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$35,743,940PYOtherExpensesAmt
CY Other Expenses$33,602,875CYOtherExpensesAmt
PY Total Expenses$69,765,046PYTotalExpensesAmt
CY Total Expenses$64,017,217CYTotalExpensesAmt
PY Revenues Less Expenses-$4,704,045PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$14,706,921CYRevenuesLessExpensesAmt
Total Assets BOY$22,061,421TotalAssetsBOYAmt
Total Assets EOY$51,853,552TotalAssetsEOYAmt
Total Liabilities BOY$10,328,315TotalLiabilitiesBOYAmt
Total Liabilities EOY$25,436,591TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$11,733,106NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$26,416,961NetAssetsOrFundBalancesEOYAmt
MissionTo operate an acute care hospital facility for the citizens of Point Pleasant, West Virginia and the surrounding communities and counties.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$52,363,470ExpenseAmt
Grant$62,078GrantAmt
Revenue$77,129,579RevenueAmt
DescThe hospital provided 36,304 acute, nursery, and skilled nursing days; 56,585 outpatient visits; 8,893 emergency room visits; 1,019 ambulatory surgeries; 636 observation visits; and 32,599 physician office visits.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$162,547ExpenseAmt
DescThe hospital operates a wellness center which provides community health education and fitness programs that are available to hospital employees and all residents of the surrounding communities.Desc
FieldValueIRS element (for citing)
Total Program Service Expenses$52,526,017TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Donor Rstr Or Quasi Endowments0DonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate HospitalYes (1)OperateHospitalInd
Audited Financial Stmt AttYes (1)AuditedFinancialStmtAttInd
Grants To OrganizationsYes (1)GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam MemYes (1)BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent0BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document69IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee734EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitYes (1)UnrelatedBusIncmOverLimitInd
Form990 T FiledYes (1)Form990TFiledInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members18GoverningBodyVotingMembersCnt
Independent Voting Member17IndependentVotingMemberCnt
Family Or Business RlnYes (1)FamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesYes (1)DelegationOfMgmtDutiesInd
Change To Org DocumentsYes (1)ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn Body0Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldNCStatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is FldNYStatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is FldWVStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Craig GillilandBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone3046754340PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line12520 Valley DriveAddressLine1Txt
CityPoint PleasantCityNm
State AbbreviationWVStateAbbreviationCd
ZIP25550ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (26 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtHighest Compensated EmployeeHighestCompensatedEmployeeInd
James Lockhart
Chairman0.50Yes (X)Yes (X)$0$0$0
Pete Allinder
Vice Chairperson0.50Yes (X)Yes (X)$0$0$00.25
Lannes Williamson
Secretary0.50Yes (X)Yes (X)$0$0$00.25
James Rossi CPA
Treasurer0.50Yes (X)Yes (X)$0$0$00.25
Mario Liberatore
Trustee0.50Yes (X)$0$0$0
Michael Lieving MD
Trustee0.50Yes (X)$0$0$0
Scott Barnitz
Trustee0.50Yes (X)$0$0$0
Annette Boyles
Trustee0.50Yes (X)$0$0$0
Jack Buxton OD
Trustee0.50Yes (X)$0$0$0
Amanda Clark
Trustee0.50Yes (X)$0$0$0
Clayton Faber
Trustee0.50Yes (X)$0$0$0
Randall Hawkins MD FACP
Trustee0.50Yes (X)$0$386,642$0
C Dallas Kayser
Trustee0.50Yes (X)$0$0$00.25
Dorsel Keefer
Trustee0.50Yes (X)$0$0$0
William Knight
Trustee0.50Yes (X)$0$0$0
Eddie Lanham
Trustee0.50Yes (X)$0$0$0
John Sauer
Trustee0.50Yes (X)$0$0$0
Thomas Willoughby
Trustee0.50Yes (X)$0$0$0
Jeff Noblin FACHE
CEO as of 9/9/1940.00Yes (X)$0$0$00.50
Glen Washington
CEO (termed 5/17/19)40.00Yes (X)$0$0$00.50
Craig Gilliland
CFO40.00Yes (X)$192,082$0$00.50
James Toothman DO
Physician40.00$352,528$0$0Yes (X)
Susan Mullooly DO
Physician40.00$513,376$0$0Yes (X)
Daniel Trent DO
Physician40.00$416,013$0$0Yes (X)
Billi Toler DO
Physician40.00$356,409$0$0Yes (X)
Thomas Cortellesi
Physician40.00$420,807$0$0Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$2,251,215TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$386,642TotReportableCompRltdOrgAmt
Total Other Compensation$0TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K19IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
Cabell Huntington Hospital
1340 Hal Greer BoulevardHuntingtonWV25701Leased Physicians and Administration Ser$1,078,997
Roche Diagnostics Corporation
PO Box 71209CharlotteNC28272Laboratory Supplies$1,040,011
NAPS Incorporated
100 Peyton Way Ste 200CharlestonWV25309Leased Professional Anesthesia Services$835,236
Seneca Medical
PO Box 5318416AtlantaGA30353Medical and Surgical Supplies$682,590
US Foods
PO Box 644540PittsburghPA15264Dietary Supplies$650,184
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K16CntrctRcvdGreaterThan100KCnt
Related Organizations$512,918RelatedOrganizationsAmt
All Other Contributions$17,229AllOtherContributionsAmt
Total Contributions$530,147TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtUnrelated Business RevenueUnrelatedBusinessRevenueAmt
Patient Services622110$47,306,776$47,306,776
Pharmacy446110$4,650,262$4,650,262
Wellness Center713940$27,844$27,844
FieldValueIRS element (for citing)
Total Program Service Revenue$51,984,882TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$539,928TotalRevenueColumnAmt
Exclusion$539,928ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$319,197RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$26,738RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$292,459RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$292,459TotalRevenueColumnAmt
Exclusion$292,459ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$58,238SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$0SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$58,238SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$58,238TotalRevenueColumnAmt
Exclusion$58,238ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
Gain on discontinued operations900099$16,852,946$16,852,946
Covid grant/revenue900099$8,360,120$8,360,120
Cafeteria & vending722212$179,826$179,826

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column-$74,408TotalRevenueColumnAmt
Related Or Exempt Func Income-$220,351RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$145,943UnrelatedBusinessRevenueAmt
FieldValueIRS element (for citing)
Other Revenue Total$25,318,484OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$78,724,138TotalRevenueColumnAmt
Related Or Exempt Func Income$77,129,579RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$173,787UnrelatedBusinessRevenueAmt
Exclusion$890,625ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$62,078TotalAmt
Program Services$62,078ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$285,151TotalAmt
Program Services$222,589ProgramServicesAmt
Management And General$62,562ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$21,299,392TotalAmt
Program Services$16,626,305ProgramServicesAmt
Management And General$4,673,087ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$627,680TotalAmt
Program Services$489,967ProgramServicesAmt
Management And General$137,713ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$6,589,622TotalAmt
Program Services$5,143,859ProgramServicesAmt
Management And General$1,445,763ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$1,550,419TotalAmt
Program Services$1,210,257ProgramServicesAmt
Management And General$340,162ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$56,105TotalAmt
Management And General$56,105ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$93,515TotalAmt
Management And General$93,515ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$9,001,421TotalAmt
Program Services$7,026,510ProgramServicesAmt
Management And General$1,974,911ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$359,902TotalAmt
Program Services$280,940ProgramServicesAmt
Management And General$78,962ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$4,069,551TotalAmt
Program Services$3,174,522ProgramServicesAmt
Management And General$895,029ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$144,104TotalAmt
Program Services$112,488ProgramServicesAmt
Management And General$31,616ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$1,226,101TotalAmt
Program Services$957,094ProgramServicesAmt
Management And General$269,007ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$92,655TotalAmt
Program Services$72,326ProgramServicesAmt
Management And General$20,329ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$170,095TotalAmt
Program Services$132,776ProgramServicesAmt
Management And General$37,319ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$1,861,882TotalAmt
Program Services$1,453,385ProgramServicesAmt
Management And General$408,497ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$711,309TotalAmt
Program Services$555,248ProgramServicesAmt
Management And General$156,061ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
Bad debts$4,817,767$4,817,767
Medical supplies$3,444,223$3,444,223
Drug expenses$2,410,666$2,410,666
Repairs and Maintenance$2,094,483$1,634,953$459,530

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$3,049,096TotalAmt
Program Services$2,698,064ProgramServicesAmt
Management And General$351,032ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$64,017,217TotalAmt
Program Services$52,526,017ProgramServicesAmt
Management And General$11,491,200ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$2,920,262BOYAmt
EOY$2,783,829EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$2,444,266BOYAmt
EOY$942,194EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$4,998,023BOYAmt
EOY$2,070,913EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$1,429,283BOYAmt
EOY$1,513,471EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$434,558BOYAmt
EOY$300,808EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$51,989,160LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$41,326,135LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$8,792,241BOYAmt
EOY$10,663,025EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
EOY$33,201,953EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$676,319BOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$366,469BOYAmt
EOY$377,359EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$22,061,421BOYAmt
EOY$51,853,552EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$6,646,967BOYAmt
EOY$7,254,083EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
EOY$7,849,618EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$2,590,000BOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$23,441BOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$1,067,907BOYAmt
EOY$10,332,890EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$10,328,315BOYAmt
EOY$25,436,591EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$11,733,106BOYAmt
EOY$26,416,961EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$11,733,106BOYAmt
EOY$26,416,961EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$22,061,421BOYAmt
EOY$51,853,552EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$14,706,921ReconcilationRevenueExpnssAmt
Other Changes In Net Assets-$23,066OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,199,905OtherCostOrOtherBasisAmt
Book Value$1,199,905BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$126,926InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis$22,856,003OtherCostOrOtherBasisAmt
Depreciation$19,589,787DepreciationAmt
Book Value$3,393,142BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$42,902OtherCostOrOtherBasisAmt
Depreciation$42,902DepreciationAmt
Book Value$0BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$24,979,062OtherCostOrOtherBasisAmt
Depreciation$19,726,469DepreciationAmt
Book Value$5,252,593BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$2,784,362OtherCostOrOtherBasisAmt
Depreciation$1,966,977DepreciationAmt
Book Value$817,385BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$10,663,025TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)

DescDescAmtAmt
Capital lease agreements$2,749,223
Estimate third party payor settlements$615,888
Due to related parties$443,389
PPP$6,524,390
FieldValueIRS element (for citing)
Total Liability$10,332,890TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart X, Line 2:FormAndLineReferenceDesc
ExplanationThe Hospital, Foundation and Health Foundation are exempt from Federal and state income taxes under Section 501(c)(3) of the Internal Revenue Code and similar state statutes relating to not-for-profit organizations. In addition, the Foundation and the Health Foundation have been classified as organizations other than a private foundation meaning of Section 509(a) of the Internal Revenue Code. Pleasant Valley Home Medical Equipment, Inc., the wholly-owned subsidiary corporation, is not exempt from Federal and state income taxes. Income tax expense, when incurred, is based upon reported income, with deferred income taxes provided on a liability method whereby deferred tax assets are recognized for deductible temporary differences and operating loss and tax credit carryforwards and deferred tax liabilities are recognized for taxable temporary differences. Temporary differences are the differences between the reported amounts of assets and liabilities and their tax bases. Deferred tax assets are reduced by a valuation allowance when, in the opinion of management, it is more likely than not that some portion or all of the deferred tax assets will not be realized. Deferred tax assets and liabilities are adjusted for the effects of changes in tax laws and rates on the date of enactment. Temporary differences result primarily from using accelerated depreciation methods and from reporting bad debts when incurred for tax purposes. Accounting principles generally accepted in the United States of America require the management of the Company to evaluate tax positions taken by the Company. Management has evaluated the Company's tax positions and concluded that the Company has maintained its tax exempt status and had taken no uncertain tax positions that require recognition or disclosure in the financial statements. Therefore, no provision or liability for income taxes has been included in the financial statements. The Company is subject to routine audits by taxing jurisdictions; however, there are currently no audits for any tax periods in progress. The management of the Company believes it is no longer subject to income tax examinations for years prior to the fiscal year ended September 30, 2017.ExplanationTxt

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (1)FinancialAssistancePolicyInd
Written PolicyYes (1)WrittenPolicyInd
All Hospitals PolicyYes (X)AllHospitalsPolicyInd
FPG Reference Free CareYes (1)FPGReferenceFreeCareInd
Percent100Yes (X)Percent100Ind
FPG Reference Discounted CareYes (1)FPGReferenceDiscountedCareInd

Discounted Care Oth Percentage DiscountedCareOthPercentageGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
Discounted Care Other100.000000000000DiscountedCareOtherPct
FieldValueIRS element (for citing)
Free Care Medically IndigentYes (1)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (1)FinancialAssistanceBudgetInd
Expenses Exceed Budget0ExpensesExceedBudgetInd
Annual Community Bnft ReportYes (1)AnnualCommunityBnftReportInd
Report Publically AvailableYes (1)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$283,628TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$20,183DirectOffsettingRevenueAmt
Net Community Benefit Expns$263,445NetCommunityBenefitExpnsAmt
Total Expense0.00440TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$14,500,312TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$12,025,278DirectOffsettingRevenueAmt
Net Community Benefit Expns$2,475,034NetCommunityBenefitExpnsAmt
Total Expense0.04110TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$14,783,940TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$12,045,461DirectOffsettingRevenueAmt
Net Community Benefit Expns$2,738,479NetCommunityBenefitExpnsAmt
Total Expense0.04550TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$4,588TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$4,588NetCommunityBenefitExpnsAmt
Total Expense0.00010TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$4,588TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$4,588NetCommunityBenefitExpnsAmt
Total Expense0.00010TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$14,788,528TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$12,045,461DirectOffsettingRevenueAmt
Net Community Benefit Expns$2,743,067NetCommunityBenefitExpnsAmt
Total Expense0.04560TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (1)BadDebtExpenseReportedInd
Bad Debt Expense$3,759,311BadDebtExpenseAmt
Reimbursed By Medicare$7,396,462ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$7,701,673CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$305,211MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (1)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (1)FinancialAssistancePrvsnInd
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Pleasant Valley HospitalBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line12520 Valley DriveAddressLine1Txt
CityPt PleasantCityNm
State AbbreviationWVStateAbbreviationCd
ZIP25550ZIPCd
FieldValueIRS element (for citing)
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd
OtherSkilled nursing facilityOtherDesc

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1Pleasant Valley HospitalBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PY0FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY0TaxExemptHospitalCYOrPYInd
CHNA ConductedYes (1)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
CHNA Conducted19CHNAConductedYr
Take Into Account Others InputYes (1)TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts0CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts0CHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (1)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLhttp://pvalley.org/community-health-needs-assessment/OwnWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Implementation Strategy AdoptYes (1)ImplementationStrategyAdoptInd
Implementation Strategy Adpt19ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (1)StrategyPostedWebsiteInd
Strategy Website URLhttp://pvalley.org/community-health-needs-assessment/StrategyWebsiteURLTxt
Organization Incur Excise Tax0OrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (1)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care100.000000000000FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care100.000000000000FPGFamilyIncmLmtDscntCarePct
Explained BasisYes (1)ExplainedBasisInd
App Financial Asst ExplnYes (1)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Includes Publicity MeasuresYes (1)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLhttps://pvalley.org/wp-content/uploads/2021/02/FAP-02.2021-revised.pdfFAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLhttps://pvalley.org/wp-content/uploads/2019/03/2019-Financial-Assistance-ApFAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLhttps://pvalley.org/wp-content/uploads/2021/02/plain-language-revised-02.20FAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill DisplayYes (X)NotifiedFAPCopyBillDisplayInd
Communtity Notified FAPYes (X)CommuntityNotifiedFAPInd
FAP Actions On NonpaymentYes (1)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection Activities0CollectionActivitiesInd
Made Effort Orally NotifyYes (X)MadeEffortOrallyNotifyInd
Made Presumptive Elig DetermYes (X)MadePresumptiveEligDetermInd
Nondis Emergency Care PolicyYes (1)NondisEmergencyCarePolicyInd
Look Back Medicare PrivateYes (X)LookBackMedicarePrivateInd
Amounts Generally Billed0AmountsGenerallyBilledInd
Gross Charges0GrossChargesInd

Supplemental Information SupplementalInformationGrp (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Pleasant Valley HospitalPart V, Section B, Line 5: First account perspectives were obtained from key community representatives through three different modes. These are: surveys, personal interviews and community interviews. These community interviews were conducted on in August and September 2019. The interviews included discussions on health care needs of the community, barriers to healthcare access, opportunities for improvement, perception of PVH and feedback on PVH's initiatives. The following organizations provided feedback: Mason County Commission, Mason County Health Department, Mason County Prevention Coalition, Mason County School System, PVH Administration, and Apple Grove Polymer Plant.
Pleasant Valley HospitalPart V, Section B, Line 11: Priority conditions include obesity and diabetes. The Hospital will continue to provide outreach and education to the residents of Point Pleasant and the surrounding communities. With a Registered Dietician on staff, the Hospital will continue to provide diabetic and weight loss education to the community. The Hospital will also continue to hold health fairs to provide low cost preventive and educational services to the community. Unhealthy lifestyle choices contribute to other health conditions. Smoking, poor nutrition, and physical inactivity are prevalent amount residents in the service area. The Hospital will continue to provide outreach and education for smoking cessation, proper nutrition and the importance of physical activity. Illicit drug use was a recurring issue of concern in many of our interviews with community members. The problems of substance abuse involve three levels of intervention: prevention, screening, and detection. These three opportunities require determined, collaborative action involving public health, education, health care, and criminal justice systems at the community level. The Hospital will maintain its collaboration and referral network to address patients needs with regards to addiction and abuse. The Hospital will continue to provide outreach and education to the residents of Point Pleasant and the surrounding communities.
Pleasant Valley HospitalPart V, Section B, Line 16j: The policy is discussed with patients before they are discharged. Copy of the policy is provided to patients prior to discharge.
FieldValueIRS element (for citing)
Facility1FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line11 - Pleasant Valley Hospital Nursing & RehabBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1640 Sand Hill RoadAddressLine1Txt
CityPoint PleasantCityNm
State AbbreviationWVStateAbbreviationCd
ZIP25550ZIPCd
FieldValueIRS element (for citing)
FacilitySkilled nursing facilityFacilityTxt

Supplemental Information Detail SupplementalInformationDetail (12 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part I, Line 7:The cost of charity care and unreimbursed Medicaid were estimated using a cost to charge ratio derived from Worksheet 2 of the Schedule H Instructions.The cost of (1) community health improvement services and community bnefit operations, (2) health professions education, and (3) cash and in-kind contributions was obtained from the hospital's accounting records.
Part I, Ln 7 Col(f):The Bad debt expense of 3,759,311 included on Form 990, Part IX, line 25, column A was subtracted for purposes of calculating the percentage of total expenses.
Part II, Community Building Activities:Our weight loss challenge gives the community the ability to use our wellness services. Our wellness services includes cardio and weight lifting machines and certified exercise physiologists. Blood pressure, weight, body fat were monitored before the challenge and after the challenge. This promotes a healthly lifestyle in the community. Mason County is a medically underserved area and the hospital spends money for recruitment for this area. The amount shown for workforce development is the amount paid to recruit new physicians to the area.
Part III, Line 2:Bad debt expense as reported on audited financial statements.
Part III, Line 3:The Hospital determined that 16% of self pay accounts turned over to a collection agency came back as eligible for Financial Aid. The amount reported is 16% of the total bad debt expense.
Part III, Line 4:Patient accounts receivable are carried at the original charge less an estimate made for doubtful or uncollectible accounts. The allowance is based upon a review of the outstanding balances aged by financial class. Management uses collection percentages based upon historical collection experience to determine collectibility. Management also reviews, troubled, aged accounts to determine collection potential. Patient accounts receivable are written off when deemed uncollectible. Recoveries of accounts previously written off are recorded as a reduction to bad debt expense when received. Interest is not charged on patient accounts receivable.
Part III, Line 8:Medicare allowable costs and reimbursements were obtained from the Medicare Cost Report.
Part III, Line 9b:Pleasant Valley Hospital has a charity care policy and a Collection and Bad Debt policy that discusses qualifying and eligibility for charity care, collection practices and handling of bad debt accounts. It is a practice to handle all patient accounts in the same manner/precedent. Patients are sent monthly statements - even while applying and pending financial assistance and will continue to receive statements until determination is made. Once determination is made the account balance or the % portion of the account balance is adjusted to "Financial Assistance".
Part VI, Line 2:We provided surveys and conducted interviews with employees, businesses, and residents of the communities we serve. We asked in the survey if they can indicate health conditions in their household. During interviews, we asked what the healthcare needs are, what barriers there are, and what opportunities for improvement do they see.
Part VI, Line 3:The process in place offers the uninsured and underinsured patient the ability to apply for charity care through a formal application process established by reviewing both income and expense to make a final determination of eligibility. It requires proper verification of income through a pay stub, tax return, etc. It is also verified that the patient is not eligible for a state assisted program via a denial letter from the program or verification through the state caseworker. The patient will either be contacted by the Business Office or will contact the Business Office during the collection and statement process to discuss financial arrangements regarding their patient account. All options of payments will be discussed and charity care offered as an alternative option after screening the patient's financial ability to make payment.
Part VI, Line 4:Pleasant Valley Hospital is a rural hospital in Point Pleasant, WV. Pleasant Valley Hospital serves mainly the people of Mason and Jackson County, WV and Meigs and Gallia County, OH. We are a federally designated medically underserved area. Mason County has 26,801 residents, the median household income is $37,322, and 17.9% are below poverty levels. Jackson County has 28,976 residents, the median household income is $40,949, and 15.7% are below poverty levels. Meigs County has 23,080 residents, the median household income is $39,640, and 21.1% are below poverty levels.Gallia County has 29,973 residents, the median household income is $39,423 and 20.6% are below poverty levels. Medicaid patients made up 20.12% of our total acute care discharges and 16.5% of our total hospital outpatient visits in FY 2018.Uninsured patients made up 1.8% of our total discharges and 1.8% of our total outpatient visits in FY 2018. There is one other not-for-profit hospital within 15 miles of PVH. They serve many of the same areas that we do.
Part VI, Line 5:The majority of the organization's governing body is comprised of persons who reside in the organization's primary service area, who are neither employees or contractors of the organization, nor family members thereof. The hospital extends medical staff privileges to all qualified physicians in its community. The hospital provides a 24 hour emergency room and is available to all regardless of the ability to pay. All the services provided by the hospital are provided regardless of the ability to pay. The hospital has an auxiliary that helps our patients and visitors if they need a wheelchair when they arrive or if they need dirctions on where to go within the Hospital. The hospital provides Breast Cancer Screenings/Mammograms free to patients who cannot pay for the service. The hospital has a fitness center for the community and it also conducts many health fairs throughout the year. The hospital provides many health screenings throughout the year in addition to a nutritional program. Our SNF provides transportation for its residents to health facilities. The hospital has support groups for members of the community. The hospital donates money to the community for various projects.

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records Maintained0GrantRecordsMaintainedInd

Recipient Table RecipientTable (3 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdIRC SectionIRCSectionDescCash GrantCashGrantAmtPurpose Of GrantPurposeOfGrantTxt
Hannan High School
1 Wildcat WayAshtonWV25503Public School$5,000School based clinic donation
Wahama High School
1 White Falcon DrMasonWV25260Public School$5,000School based clinic donation
Point Pleasant High School
280 Scenic DrPoint PleasantWV25550Public School$20,000School based clinic donation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Travel For CompanionsYes (X)TravelForCompanionsInd
Discretionary Spending AcctYes (X)DiscretionarySpendingAcctInd
Club Dues Or FeesYes (X)ClubDuesOrFeesInd
Written Policy Ref T And E ExpnssYes (1)WrittenPolicyRefTAndEExpnssInd
Substantiation RequiredYes (1)SubstantiationRequiredInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (7 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
Randall Hawkins MD FACP
Trustee$0$300,236$0$59,130$0$27,276$0$0$0$0$0$386,642$0$0
Craig Gilliland
CFO$176,843$0$15,101$0$138$0$0$0$0$0$192,082$0$0$0
James Toothman DO
Physician$114,510$0$0$0$238,018$0$0$0$0$0$352,528$0$0$0
Susan Mullooly DO
Physician$513,136$0$102$0$138$0$0$0$0$0$513,376$0$0$0
Daniel Trent DO
Physician$415,149$0$102$0$762$0$0$0$0$0$416,013$0$0$0
Billi Toler DO
Physician$351,762$0$102$0$4,545$0$0$0$0$0$356,409$0$0$0
Thomas Cortellesi
Physician$410,549$0$0$0$10,258$0$0$0$0$0$420,807$0$0$0

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part I, Line 3The CEO of Pleasant Valley serves under a management contract governed by Cabell Huntinton Hospital. PVH is not part of the process in determing the CEO's compensation. PVH pays CHH a monthly salary fee.
Form 990, Part VII, Section A, Line 5Unrelated organization officer compensation: For the calendar year ended, 12/31/2019, Pleasant Valley Hospital paid Cabell-Huntington Hospital $178,485.74 for the services of Glen Washington, CEO of Pleasant Valley Hospital, Inc., through 5/17/2019. For the calendar year ended, 12/31/2019, Pleasant Valley Hospital paid Cabell-Huntington Hospital $133,256.15 for the services of Fred (Jeff) Noblin, CEO of Pleasant Valley Hospital, Inc.

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp

Name Of Interested NameOfInterested

FieldValueIRS element (for citing)
PersonJane ZirklePersonNm
FieldValueIRS element (for citing)
Relationship DescriptionFamily member of Mike Lieving, Hospital TrusteeRelationshipDescriptionTxt
Transaction$25,123TransactionAmt
TransactionWagesTransactionDesc
Sharing Of Revenues0SharingOfRevenuesInd

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (9 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part VI, Section A, line 2Dallas Kayser and Charles Lanham have a business relationship. Mario Liberatore and Lannes Williamson have a business relationship. Dallas Kayser's spouse and James Rossi have a business relationship.
Form 990, Part VI, Section A, line 3For the calendar year ended, 12/31/18, Pleasant Valley Hospital paid Cabell- Huntington Hospital $428,191 for the services of Glen Washington, CEO of Pleasant Valley Hospital.
Form 990, Part VI, Section A, line 4There were changes to the articles of incorporation and bylaws due to the spinoff of Pleasant Valley Nursing and Rehabilitation Center (PVNRC), a skilled nursing facility, into its own corporation on 4/6/2020, in anticipation of selling it. The new corporation was wholly owned by Pleasant Valley Hospital, and the Pleasant Valley Hospital officers acted as the officers of PVNRC.
Form 990, Part VI, Section B, line 11bThe 990 is prepared by the Hospital's independent accountants. For the 2019 990, the CFO and Controller reviewed the 990 prior to filing and the board will review the return at their next scheduled meeting.
Form 990, Part VI, Section B, line 12cEach board member fills out a questionnaire at the end of the fiscal year. The questionnaire has questions on it that determine independence status and other relationships between board members and between the board member and the hospital. This helps in determining possible conflicts that may arise. In addition, the board members must sign a conflict of interest policy that requires them with due diligence to state that they have a conflict of interest when that conflict arises. The board member must leave the board meeting during discussions and voting.
Form 990, Part VI, Section B, line 15Pleasant Valley Hospital has a pay grade for each job code. The pay grade is a range of wages that can be paid to an individual for that job title. When an officer, other than the CEO, is offered the position. The Director of Human Resources and the CEO negotiates a salary with the candidate within the pay grade. The pay grade was established using independent data. Pleasant Valley Hospital Board of Trustees reviews and approves the contract for the CEO.
Form 990, Part VI, Section C, line 19These documents are available upon request for inspection at the hospital or by mailing a copy upon request.
Form 990, Part IX, line 11gPurchased Services: Program service expenses 2,307,945. Management and general expenses 648,685. Fundraising expenses 0. Total expenses 2,956,630. Nursing Services: Program service expenses 197. Management and general expenses 55. Fundraising expenses 0. Total expenses 252. Lab Services: Program service expenses 24,529. Management and general expenses 6,894. Fundraising expenses 0. Total expenses 31,423. Medical Services: Program service expenses 521,854. Management and general expenses 146,675. Fundraising expenses 0. Total expenses 668,529. Doctor Services: Program service expenses 3,042,395. Management and general expenses 855,113. Fundraising expenses 0. Total expenses 3,897,508. Therapy Services: Program service expenses 233,498. Management and general expenses 65,628. Fundraising expenses 0. Total expenses 299,126. Pharmacy Services: Program service expenses 545,400. Management and general expenses 153,293. Fundraising expenses 0. Total expenses 698,693. Administration Services: Program service expenses 350,692. Management and general expenses 98,568. Fundraising expenses 0. Total expenses 449,260.
Form 990, Part XI, line 9:Nondeductible tax penalties -23,066.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (4 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtDirect Controlling NADirectControllingNACdControlled OrganizationControlledOrganizationInd
Pleasant Valley Hospital Foundation Inc
2420 Valley DrPt PleasantWV25550200120079FundraisingWV501(c)(3)Line 11N/A0
Pleasant Valley Hospital Health Foundation Inc
2420 Valley DrPt PleasantWV25550550649849Scholarships/HealthcareWV501(c)(3)Line 12c, III-FIN/A0
Pleasant Valley Medical Group Inc
2520 Valley DrPt PleasantWV25550471358788HealthcareWV501(c)(3)Line 11N/A0
Pleasant Valley Nursing and Rehabilitation Center Inc
2520 Valley DrPt PleasantWV25550850796458HealthcareWV501(c)(3)Line 3N/A0

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp

Related Organization Name RelatedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1Pleasant Valley Home Medical EquipmentBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1Viand StAddressLine1Txt
CityPt PleasantCityNm
State AbbreviationWVStateAbbreviationCd
ZIP25550ZIPCd
FieldValueIRS element (for citing)
EIN550653315EIN
Primary ActivitiesRetail - Medical equipment sales & rentalPrimaryActivitiesTxt
Legal Domicile StateWVLegalDomicileStateCd
Direct Controlling NAN/ADirectControllingNACd
Entity TypeCEntityTypeTxt
Share Of EOY Assets$47,371ShareOfEOYAssetsAmt
Ownership1.00000OwnershipPct
Controlled OrganizationYes (1)ControlledOrganizationInd
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org0GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other OrgYes (1)AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other Org0PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees Sharing0PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (1)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd